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CaringNovember 3, 2016
Headlines
PeriOperative Nursinga highly specialized practice contributing
to optimal patient outcomes
Nursing and Patient Care ServicesM a s s a c h u s e t t s G e n e r a l H o s p i t a l
See story on page 4
Perioperative staff nurses, Natalie Bonvie, RN (left), and Rachel Eaton, RN,conduct pre-operative interview.
Page 2 — Caring Headlines — November 3, 2016
Jeanette Ives Erickson
continued on next page
Jeanette Ives Erickson, RN, senior vice presidentfor Patient Care and chief nurse
Nurses play key role in detecting and preventing
C. difficileCDIs are more
likely to affect older
individuals in hospitals
and long-term care
facilities, typically after
the use of antibiotic
medications; but
more and more CDI
is occurring among
populations not typically
considered high risk,
such as younger, healthy
individuals without a
history of antibiotic
use or inpatient
hospitalization.
reventing and controlling clos- tridium difficile infection (CDI) is an ongoing challenge for hos- pitals and healthcare facilities across the country. CDI, also called C. difficile or C. diff, is a bacteria that can cause symp-toms ranging from diarrhea to life-threatening inflammation of the colon. CDIs are more likely to affect older individuals in hospitals and long-term care facilities, typically after the use of an-tibiotic medications; but more and more CDI is occurring among populations not typically con-sidered high-risk, such as younger, healthy indi-viduals with no history of antibiotic use or inpa-tient hospitalization.
The Centers for Disease Control and Preven-tion estimate that each year, 450,000 cases of C. difficile infection in the United States result in approximately 15,000 deaths. Research shows that CDIs are preventable with effective infection - control practices and the judicious use of antibi-otics. Prevent ing C. difficile infection is a top priority of President Obama’s National Action Plan to Combat Antibiotic Resistant Bacteria, launch ed in March of 2015.
In all hospitals, but especially those that practice relationship-based care, as we do, nurses play a critical role in detecting and preventing C. difficile infections. Nurses are instrumental in:
• Detection: C. difficile is highly transmissible in healthcare settings making early detection of new cases critical to preventing the spread of infection. The primary symptom of C. difficile is diarrhea; nurses at the bedside are likely to be-come aware of this symptom sooner than other clinicians. Detection is even more crucial in pa-tients who are unable to communicate (due to mechanical ventilation, dementia, and other factors)
• Initiating isolation: Rapid initiation of Contact Isolation Plus is essential in preventing the spread of C. difficile. Delaying isolation increases the risk of transmission. In almost all instances, nurses are the ones who initiate Contact Isola-tion Plus for patients with known or suspected C. difficile, and they’re most often the ones who notify other departments (such as Admitting and Infection Control)
P
November 3, 2016 — Caring Headlines — Page 3
Jeanette Ives Erickson (continued)
When it comes
to protecting
patients against
aggressively
transmissible
infections such
as C. difficile and
Methicillin-resistant
Staphylococcus
aureus (MRSA),
nurses are our first
line of defense.
Build ing trusting
relationships
with patients and
employing the best
infection-control
practices go a
long way toward
detecting and
preventing
infection.
• Monitoring: Studies show that healthcare provid-ers, support staff, visitors, and patients themselves frequently fail to follow proper hand-hygiene and contact-isolation protocols. The effectiveness of contact isolation is greatly enhanced when nurses work to promote compliance
• Testing: Collecting stool samples for testing is important in diagnosing C. difficile. Reliable, true -positive results can only be obtained from liquid stool. In most instances, nurses are called upon to collect diagnostic samples from patients who might have C. difficile, so it’s vital that nurses know which specimens to collect and how to send them for testing
• Environmental cleaning: It’s well known that C. difficile contaminates the rooms of patients infected with it. Nurses are familiar with the patient’s care environment, so they’re in a posi-tion to be able to identify surfaces that may be contaminated and need to be cleaned and disin-fected. Environmental cleaning is more effective when nurses collaborate with Environmental Ser-vices staff to ensure all appropriate surfaces are cleaned and disinfected
• Antibiotic exposure: Exposure to antibiotics is the single most important risk factor for C. diffi-cile infection. Improving antibiotic use through ‘antibiotic stewardship’ is key to reducing C. diffi-cile infection. Even nurses who don’t prescribe antibiotics play an important role when they col-lect specimens to ensure optimal utilization of an-tibiotics; ensure the correct administration of an-tibiotics; track antibiotic use; and re-visit the use of antibiotics as patients’ clinical conditions change
We all play a role in keeping patients safe. But when it comes to protecting patients against aggres-sively transmissible infections such as C. difficile and Methicillin-resistant Staphylococcus aureus (MRSA), nurses are our first line of defense. Build-ing trusting relationships with patients and employ-ing the best practices of early detection, Contact Isolation Plus, monitoring, effective specimen-test-ing, maintaining a clean and disinfected environ-ment, and strong antibiotic stewardship, go a long way toward detecting and preventing infection.
For more information, contact Dee Dee Suslak in the Infection Control Unit at 617-724-3076.
In this IssuePerioperative Nursing .....................................................1
Jeanette Ives Erickson ...............................................2-3• Detecting and Preventing C. difficile
Perioperative Nursing ..............................................4-5
Patient Education ...............................................................6• Focusing on Nutrition
Disabilities Awareness Booth ......................................7
Clinical Narrative ........................................................8-9• Stephanie Neville, RN
The Molly Catherine Tramontana Award ........10
Pre-Admission Testing Area: Pre-Procedure Evaluation Phone Program .................................11
Fielding the Issues ..........................................................12•On-Line Translation Programs and Apps
Not Appropriate in the Medical Setting
Acute Pain Opioid Guidelines ................................13
Professional Achievements .......................................14
Announcements .............................................................15
HCAHPS ............................................................................16
Page 4 — Caring Headlines — November 3, 2016
ccording to the Association of PeriOperative Registered Nurses (AORN) “The prac- tice of perioperative nurs- ing requires specialized knowledge and skills that contribute to optimal patient outcomes.” This statement is a good starting point in understanding the scope of perioperative nursing at MGH where the spe-cialty is a dynamic, fast-paced, nursing practice. As an integral part of the multi-disciplinary surgical team, perioperative nurses care for 35,000 patients per year. Many nurses who transition to the periop-erative setting say it’s something they’ve always been interested in but didn’t really know what it was all about. That interest spurred the department to spotlight perioperative nursing practice and its contributions to positive patient outcomes.
Perioperative nursing conducts several orienta-tion programs comprised of both hands-on practice and didactic education as prescribed by AORN. Nurses who complete the Perioperative Nursing 101 Orientation Program find they’re well prepared for independent practice. Recent graduates found the orientation model very supportive, describing staff development nurses and preceptors as caring and committed to the success of orientees.
With an eye toward continuous improvement, the program is revised based on feedback received after each program. Caitlin Yeaton, RN, a general medicine nurse with six years experience, observed that classroom experiences were so valuable, espe-
cially once she got into the OR environment. She recommended reversing the ratio of classroom time to hands-on experience.
Interviews with recent perioperative nursing graduates generated some common themes: patient care, safety, teamwork, and active engagement in daily learning. This OR environment is fast-paced and dynamic; no two days are ever alike. Caring for patients undergoing cutting-edge procedures is ex-citing and intriguing for perioperative nurses. Many nurses are surprised by the technical aspects of perioperative nursing, but the human side of caring for patients is the same no matter the setting. The busyness and technical components of surgery don’t distract perioperative nurses from their primary goal — delivering the highest quality, compassion-ate, patient-focused care.
Samantha Herwig, RN, says, “I like the time be-fore cases begin; that’s when I can spend time with patients and comfort them before surgery.”
Interacting with patients, connecting with them, calming them, is the highest priority for periopera-tive nurses. Laura Clancy, RN, says, “I like the team effort, working together with techs, surgeons, resi-dents, interns, and anesthesiologists.”
Says Bonnie Spencer, RN, “I like the one-to-one patient care.”
Though rooted in tradition, perioperative nurs-ing at MGH is evidence-based. We have nurses who’ve worked in the OR setting for more than 40 years, and we have nurses who are new to the perioperative setting — some new graduates, some who are just new to MGH, and some who’ve transi-
PeriOperative Nursinga highly specialized practice contributing
to optimal patient outcomes— by Maureen Hemingway RN, nursing practice specialist, Operating Rooms
PeriOperative Nursing
A
continued on next page
Perioperative
nursing at MGH
is a dynamic, fast-
paced, nursing
specialty. As an
integral part of the
multi-disciplinary
surgical team,
perioperative
nurses care for
35,000 patients
per year.
November 3, 2016 — Caring Headlines — Page 5
PeriOperative Nursing (continued)
tioned to perioperative nursing from other special-ties within the hospital.
OR nurses are members of multiple teams, com-ing together in various combinations to care for specific patients. These teams all share a mental model of patient care. Many OR nurses say they value teamwork above all else.
Tayla Hussey, RN, says, “It’s so nice to work as part of a multi-disciplinary team because physicians are right there whenever there’s a question.”
Katie Zager, RN, says, “I love delivering care in this model. Teamwork is huge.”
Says Jennifer Tavernelli, RN, “The nurse brings everyone together. The nurse is the one who makes sure that everyone is one the same page.”
These sentiments are reflected in the care they deliver. Conducting universal protocols (often driven by nurses) enhances communication and allows the team to plan for individualized patient care. Coordination of care is a hallmark of patient safety.
Perhaps Natalie Bonvie, RN, described it best: “The nurse is a member of a well-orchestrated team. Everyone has a specific job, but it’s the nurse who coordinates everything. As an OR nurse, I’m responsible for reassuring my patients, preparing them for surgery, checking orders, and providing a safe environment. Every one of those steps is crucial.”
Providing a safe environment is a common theme in the OR setting, and work-ing together is part of the culture.
Says Lisa Liu, RN, “Every day that I’m involved with good team-work is a good day.”
Perioperative nurses are a vital part of patient care at MGH. Rachel Eaton, RN, says, “When I leave, I can honestly say I did a good job. I think about my patients when I get home, and I’m excited to come back each day. I feel like I have a positive work-life balance.”
The perioperative environment is supportive and encouraging. Says Kristen Kelly, RN, “I love my fellow nurses, my team leader, and my clin-ical nurse manager.”
The general public may not be 100% clear about what perioperative nurses do, but they can rest assured that our team is committed to pro-viding the highest quality care to our patients by working closely together with our physician colleagues and one another.
For more information or if you’re interested in becoming a periopera-tive nurse, come to the perioperative open house, November 18, 2016, from 9:00am–1:00pm in Lunder 234, or call Patrice Osgood, RN, nursing director, at 617-724-3604.
Bonvie (left) and Eaton review patient’s chart
post-procedure.
Page 6 — Caring Headlines — November 3, 2016
Patient Education
Focusing on nutritioninter-disciplinary collaboration ensures patients’
nutritional needs are met— submitted by the PCS Patient Education Committee
atients, family members, nurses, physicians, and dietitians all play an important role in developing the nutrition care plan. In their interac- tions with patients, clinicians can reinforce the importance of optimal nutrition in promoting healing and fostering a healthy lifestyle. The initial nursing assessment (INA) helps identify patients at risk for poor nutrition. The Malnutrition Screening Tool (MST), implemented with the launch of eCare, prompts nurses to offer oral nutritional sup-plements and/or consult a dietitian based on the re-sults of the MST screening. This initial assessment along with the patient’s medical history helps deter-mine the patient’s nutritional needs and care plan.
Some information that helps identify patients at risk include: knowing if they were eating well prior to admission. Have they lost weight recently without trying? Do they have problems chewing or swallow-ing? Will their ability to eat be affected by their ill-ness and/or treatment plan? Are there cultural pref-erences or food allergies to consider?
Other factors that can interfere with adequate food intake include nausea, vomiting, changes in taste, and poor appetite. The presence or absence of these factors can change over time. If you determine that a patient has any of these nutritional challenges, alert Nutrition & Food Services. It’s helpful if clini-cians inform patients that their diets may change due to restrictions, tests, procedures, or as medical issues arise.
Care is most effective when all members of the care team collaborate to ensure a patient’s nutri-tional needs are met.
• Nutrition service coordinators (NSCs) provide menus for food selection and notify the care team about food allergies, preferences, and other ac-commodations the patient may need
• Registered dietitians (RDs) are food and nutri-tion experts who, when consulted, determine the appropriate nutritional care plan for patients given their medical history and reason for current admission. Registered dietitians advise patients and nurses around best practices to increase oral intake and arrange for supplements as necessary. In some cases, they may recommend alternative therapies (enteral feedings or parenteral nutri-tion). They also provide patient education
• Registered nurses (RNs) help plan, implement, monitor, and evaluate the nutrition care plan and educate patients about the rationale for diet re-strictions or changes
• Physicians (MDs) place diet orders based on cur-rent medical diagnoses and physical exams. They make medically driven changes when necessaryWhenever possible, family members and caretak-
ers should be included in teaching sessions. Their participation during discharge education is essential to ensuring patients’ needs are met at home. Respect-ing culture and food preferences is important in di-etary planning. All visitors should check with the nurse to confirm that food brought from home is in alignment with the patient’s dietary plan.
Registered dietitians can answer any questions you may have regarding optimal nutrition. Outpatient services are available for follow-up and long-term management. For more information, consult your registered dietitian through the on-call directory or during multi-disciplinary rounds.
PCare is most
effective when
all members of
the care team
collaborate to
ensure a patient’s
nutritional needs
are met.
Patients, family
members, nurses,
physicians, and
dietitians all play
an important
role in developing
the nutrition
care plan.
November 3, 2016 — Caring Headlines — Page 7
Raising Awareness
The MGH Council on Disabilities Awareness
n Tuesday, October 11, 2016, the MGH Council on Disabilities Awareness sponsored its annual Disabilities Awareness Booth in the Main Corridor to share information and educate the MGH community on how to make the hospital a more welcoming and accessible place for all. Staff were on hand to answer questions and disseminate information about the resources available at MGH for individuals with disabilities.Patients and visitors:• The MGH Accessibility website, www.massgeneral.org/accessi-
bility, houses information on transportation, parking, entrances, escorts, adaptive equipment, communication, and amenities
• The MGH Disabilities Program supports patients with disabilities with visit planning, accommodations, and much more. Call 617-726-3370 or e-mail: MGHAccessibility@partners.org
Staff: • Look for the FYI flag on the patient’s chart in
eCare to identify patients with disabilities who may need special accommodations
• The MGH Accessibility Resources (MARS) Share-Point site houses information on best practices, guide-
lines on caring for people with visual, hearing, and cognitive im-pairments, and people with autism spectrum disorders
• The PCS Excellence Every Day Portal contains communication and etiquette tips, our service animal policy, and information about assistive devices and other resources
• HealthStream modules are available to help educate staff around working and interacting with individuals with disabilities
Employees with disabilities:• The Employees with Disabilities Resource Group (EDRG) pro-
vides networking opportunities, social connection, and collabo-ration to MGH employees with disabilities (http://sharepoint.
partners.org/mgh/mghedrg/SitePages/Home.aspx) • The Partners Employment Assistance Program offers
support to employees with disabilities (or who may be caring for a family member with a disability) by find-ing internal specialists or community resources (http://eap.partners.org/ or call 866-724-4EAP)• Every MGH employee has an HR business partner
(formerly ‘generalist’) who is available to answer all personnel questions. Find your HR business partner at
http://hr.partners.org/mgh/hr-contacts.aspx
O
Above (l-r): Sheila Golden-Baker, RN, professional development specialist; Zary Amirhosseini, disabilities program manager; and Joe Crowley, senior manager for Police & Security, staff disabilities awareness booth in the Main Corridor.
Page 8 — Caring Headlines — November 3, 2016
Clinical Narrative
continued on next page
New nurse learnsvaluable lesson about the
essence of nursingcritical thinking can only be learned
through hands-on experience
Two months
after completing my
orientation, I was assigned
to an elderly woman
who was experiencing
respiratory distress.
Over the course of her
hospitalization, she had
been intubated due to
worsening respiratory
failure, and she had
become septic requiring
high-dose pressors.
MStephanie Neville, RN,new graduate nurse
y name is Stephanie
Neville, and I am a new
graduate nurse in the
Blake 7 Medical Inten-
sive Care Unit (MICU).
Earlier this year, just
two months after completing orientation, I was
assigned to care for an elderly woman who was
experiencing respiratory distress. Over the
course of her hospitalization, she had needed to
be intubated due to worsening respiratory fail-
ure, and she had become septic requiring high-
dose pressors. But Mrs. P had turned a corner by
the time I met her, and at the start of my shift,
she’d been off of pressors for more than 24 hours.
When I met Mrs. P, she seemed like a ‘typical’
MICU patient; little did I know that later in my
shift she would begin to rapidly decompensate.
After an uneventful morning, I was surprised
to hear Mrs. P’s vent alarm since it had been
quiet all shift. When I went into her room, I was
shocked to see her endotracheal tube filled
with frank red blood. She was hypotensive and
not ventilating. I alerted the nearest nurse and
asked her to suction Mrs. P so I could urgently
page the medical team and respiratory thera-
pist. Everyone showed up quickly while I con-
tinued to suction blood from the endotracheal
tube and start her back on pressors. I tried to
remain calm while explaining to everyone in
the room the events that had occurred prior to
their arrival. I was quickly supported by fellow
nurses who jumped in to help titrate pressors
November 3, 2016 — Caring Headlines — Page 9
Clinical Narrative (continued)
Someone once
told me that as
a new graduate
nurse, you can
be taught nursing
skills. But the
critical thinking,
communication, and
compassion that
comes with being
a nurse can only
be learned through
experience and
caring for patients
at the bedside.
In the past year
I’ve learned more
than I ever thought
possible — from my
preceptors and my
experiences.
and order more blood. The whole team worked to-
gether while discussing treatment options to stabi-
lize Mrs. P.
I had learned in report that Mrs. P was DNR (do
not resuscitate) and her family did not want to es-
calate care. No family members were present at the
moment; so I knew I had to advocate for Mrs. P to
make her wishes known.
As the medical team ordered an emergency
bronchoscopy and massive transfusions, we were
close to maxing out on three pressors. I asked the
team to contact the family to let them know what
was happening and see if they wanted us to proceed
with these measures. I reminded them that the fam-
ily did not want to escalate care.
After numerous phone calls to try to reach the
family, we were able to speak with Mrs. P’s health
care proxy. We explained that Mrs. P’s condition
was unstable and made sure she understood that
any efforts to keep her alive would involve invasive
procedures and life support. Mrs. P’s health care
proxy felt sure that Mrs. P would not want any in-
vasive procedures.
We immediately transitioned to comfort mea-
sures only, and I requested a Dilaudid drip. I did ev-
erything I could to help Mrs. P pass peacefully. We
stopped pressors and removed her endotracheal
tube. I stayed by her side until she passed away a
few moments later.
Someone once told me that as a new graduate
nurse, you can be taught nursing skills. But the crit-
ical thinking, communication, and compassion that
comes with being a nurse can only be learned
through experience and caring for patients at the
bedside.
This past year I learned more than I ever
thought possible — from my preceptors and from
my experiences. But no amount of orientation
could have prepared me for what to expect or how I
would feel during my first unexpected death as a
nurse.
I was overwhelmed. But as horrible as that expe-
rience was, I look back now and know I did every-
thing in my power to help Mrs. P. Yes, the pressors,
the blood, the labs, the bronchoscopy, and all the
other interventions were important. But the most
important thing I did that day was advocate for my
patient and make her wishes known when no one
was there to speak for her. As tragic as her passing
was, Mrs. P passed peacefully, according to her
wishes, and with dignity.
Comments by Jeanette Ives Erickson, RN,senior vice president for Patient Care and chief nurse
Moving from the structure and security of the aca-
demic setting into clinical practice is a major transi-
tion, one every veteran clinician can vividly recall.
Stephanie was thinking Mrs. P’s recovery was pro-
gressing on track when without warning, everything
changed. But Stephanie was well-trained, and she
had good instincts. Despite the rapidly changing
situation, she did what nurses do; she advocated for
her patient; she worked with the team to give Mrs.
P the best possible care; and she took advantage of
the knowledge and experience of her more experi-
enced colleagues. Every day, clinicians come to
work not knowing what to expect, prepared to do
whatever it takes for their patients and colleagues,
just as Stephanie and her team did.
Thank-you, Stephanie
Page 10 — Caring Headlines — November 3, 2016
Recognition
2016 Molly Catherine Tramontana Award
— by Michele O’Hara, RN, nursing director, Labor & Delivery
he Molly Catherine Tramontana Award for Outstanding Service and Patient Care recognizes labor and delivery nurses who provide exemplary care to grieving fam- ilies. The award, established in 2007 by Mark and Jennifer Tramontana in memory of their daughter, Molly Catherine, provides funding that enables a labor and delivery nurse to attend an an-nual bereavement conference.
Each year, the Tramontana family, leadership of Vincent OB-GYN, labor and delivery nurses, and MGH Trustee, Gardner Jackson, celebrate Molly
Catherine’s memory by honoring a nurse (or nurses) who provide exceptional care to a family that has experienced unexpected loss.
This year’s recipient was Janet Palermo, RN, a labor and delivery nurse for more than 25 years. Palermo was nominated by fellow nurses, Lois Richards, RN, and Jen Bernard, RN, who were with Palermo when one of her patients experienced an unexpected loss.
Said Richards, “Janet stayed with her patient through the entire labor process, never leaving the family’s side. With tears in her eyes, she continued to give loving care to this patient and her family. I have so much respect for Janet’s nursing abilities.
She is the epitome of the art of nursing.”
Said Bernard, “Janet was a wonderful example that day. Every day that Janet works she exempli-fies the qualities of a Tra-montana award recipi-ent.”
We’re grateful to the Tramontana family for their continued support of excellence in obstetri-cal nursing care.
For more information about the Tramontana Award or to nominate a colleague for recognition, contact Michele O’Hara, RN, nursing director, at 617-724-1878.
T(L-r): Michele O’Hara; Katherine Kruczinski;
Susan Cahill; Jeff Ecker ; Janet Palermo; Jenn and
Mark Tramontana and their children; Beth West;
and Lois Richards.
(Pho
to p
rovi
ded
by s
taff)
November 3, 2016 — Caring Headlines — Page 11
i, my name is Debbie. I’m a nurse in the Pre-Procedure Eval- uation Phone Program at MGH. I’m calling to gather some health information for your upcoming procedure. No, you don’t have to come in; we can do it over the phone. When you come in on the day of your procedure, your anesthesia provider will have al-ready reviewed the information we’re discussing.”
Every week, nurses in the Pre-Procedure Evalu-ation (PPE) Phone Program call hundreds of pa-tients scheduled for procedures requiring anesthesia. Historically, patients had to come to the hospital to meet with an anesthesia provider, but today, more and more patients are completing their PPEs over the phone with a nurse.
The process for scheduling a PPE begins when the surgeon confirms a date for surgery. Patients are asked to complete an on-line questionnaire prior to the phone call so the nurse will have some back-ground information in advance.
On the day of the phone call, the nurse reviews the patient’s responses to the questionnaire and adds relevant details for the anesthesia team. Home medications are updated, and instructions are given as to which medications the patient should take (or not take) on the morning of surgery. Patients are given information on how to prepare and what to expect on the day of the procedure.
Ideally, the pre-procedure interview is conducted two to four weeks prior to non-emergent procedures. Once the interview is completed, an attending an-esthesiologist reviews the information. If the anes-
thesiologist requires more, he or she will contact the appropriate provider, patient, or facility to ob-tain the necessary information.
When the patient arrives at the hospital for their procedure, perioperative nurses and anes-thesia providers review the PPE information. Having the information in advance allows pro-viders to ‘know’ the patient and individualize their care accordingly.
In addition to being convenient, the PPE Phone Program has proven to be a reliable me-thod for pre-screening patients. Surgical cancella-tions are greatly reduced because of the thorough screenings conducted by PPE nurses and attend-ing anesthesiologists.
Currently, more than 1,000 calls a month are made by PPE nurses. In 2015, more than 13,000 patients were pre-screened over the phone. The program also encompasses patients in nursing homes, rehabilitation facilities, and group homes. In those cases, a PPE nurse contacts the nurse caring for the patient and gathers information, eliminating the need for an ambulance ride to the hospital. As of January 1, 2017, with the closing of the Pre-Ad mission Testing Clinic in the Jackson Building, the program will expand to in-clude those patients, as well.
Staff of the Pre-Procedure Evaluation Phone Program say it’s been exciting to be part of a pro-gram that has grown and changed so significantly over the years, adapting to meet the needs of the patient and the perioperative team.
For more information, call 617-643 2555.
Pre-Admission Testing Area
Pre-Procedure Evaluation Phone Program
— by Donna Van Kleeck, RN, and Karen Parmenter, RN
‘‘HCurrently, more
than 1,000 calls a
month are made by
PPE nurses. In 2015,
more than 13,000
patients were pre-
screened over the
phone... With the
closing of the Pre-
Admission Testing
Clinic in January, the
program will expand
to include those
patients, as well.
Page 12 — Caring Headlines — November 3, 2016
Why on-line translation programs and apps are a ‘no-no’
in the medical settingQuestion: I recently discovered Google Translate on-line, and I’m thinking it would be great to use for translating documents for my patients. Is there any reason I shouldn’t use it?
Jeanette: Unfortunately, many inaccuracies have been associated with on-line translation programs, which poses a safety risk for patients. In a study pub-lished in the electronic journal, BMJ, Sumant Patil and Patrick Davies from Nottingham Child ren’s Hospital in the UK, concluded that Google Trans-late has only a 57.7% accuracy rate when used for medical translation. Serious errors have been found in translations. For example, “Your husband had a cardiac arrest,” was translated in one language as, “Your husband has an imprisonment of the heart.” In another language, “Your husband has the oppor-tunity to donate his organs,” became, “Your husband can donate his tools.” Google Translate and other on-line translation programs should not be used to translate any medical materials, especially those in-volving consent, discharge instructions, medication instructions, and diagnosis information.
Question: What do you recommend for translat-ing documents?
Jeanette: MGH Medical Interpreters Services provide translation of written materials. You can reach them at 617-726-6966 or by e-mail at MGHTranslations@partners.org.
Question: Can I use a smart-phone app to inter-pret for patients?
Jeanette: Once again, where we can’t ensure the accuracy of these programs, to protect our patients, they should not be used in the medical setting. On-line programs and apps don’t allow for two-way communication. Using a trained medical interpreter (in person, by video, or by phone) ensures effective communication and meets compliance standards set by The Joint Commission.
Question: Can my Spanish-speaking col-league serve as an interpreter for me?
Jeanette: We should only rely on qualified medical interpreters to communicate with pa-tients and families. Though many of our bilin-gual colleagues are willing to help, asking indi-viduals who haven’t been assessed for language fluency to interpret for us poses a safety risk. Studies show that encounters facilitated by un-trained interpreters have a larger percentage of errors with clinical significance than those facili-tated by professional interpreters. Relying on in-dividuals whose primary role is not interpreting puts them in the difficult position of working outside their scope of practice. And working with qualified medical interpreters is also in ac-cordance with the new Affordable Care Act re-quirement.
For more information, contact Medical Interpreter Services at 617-726-6966, or refer to your orange RACE card where it’s listed under Emergency phone numbers.
Fielding the Issues
Unfortunately,
many inaccuracies
have been
associated with
on-line translation
programs, which
poses a safety risk
for patients.
MGH Medical
Interpreters
Services provide
translation
of written
materials.
November 3, 2016 — Caring Headlines — Page 13
Page 14 — Caring Headlines — November 3, 2016
Professional Achievements
McAdams appointedEileen McAdams, RN, nurse practitioner, Charlestown
HealthCare Center, was appointed a global health scholar by the
MGH Center for Global Health, in September, 2016.
McKenna Guanci appointed
Mary McKenna Guanci, RN, clinical nurse specialist, Neurology, was
appointed a member of the Board of Directors for the Boston chapter
of the American Association of Neuroscience Nurses.
Staples presents posterMonica Staples, RN, clinical
nurse specialist, MGH Center for Disaster Medicine, presented her poster, “Team Training in High-Risk
Environments,” at the Disaster Health Education Symposium at the
Uniformed Services University in Bethesda, Maryland, September 8, 2016.
Inter-professional team presents
Leslie Portney, PT; Gaurdia Banister, RN; Carmen Vega-Barachowitz, CCC-SLP; Mary Knab, PT; and
Maureen Schnider, RN, presented, “Strengthening the Academic
Practice Partnership to Support Inter-Professional Clinical Education,”
at the eighth international conference, All Together Better
Health, in Oxford, England, September 7, 2016.
Nurses presentAmanda Bulette Coakley, RN,
staff specialist; Jane Flanagan, RN, nurse scientist; and Christine Annese, RN, staff specialist, presented, “Exploring the
Experience of Pet Therapy on Patients and Staff in the Acute Care
Setting,” at the ninth European Congress on Integrative Medicine
in Budapest, Hungary, September 10, 2016.
Bernhardt appointedJean Bernhardt, director of the
Charlestown HealthCare Center, was appointed a global health scholar
by the MGH Center for Global Health, in September, 2016.
McLaughlin appointedSharon McLaughlin, RN, nurse
practitioner, Charlestown HealthCare Center, was appointed
a global health scholar by the MGH Center for Global Health, in
September, 2016.
Algeri certifiedSuzanne Algeri, RN, nursing director,
Neuroscience Unit, became certified as a nurse executive by
the American Nurses Credentialing Center, in September, 2016.
Algeri presentsSuzanne Algeri, RN, nursing director,
Neuroscience Unit, presented, “Nursing Care of the Stroke Patient at Massachusetts General Hospital,”
at the seventh annual Nursing Symposium at Fudan University
Huashan Hospital in Shanghai, China, September 21, 2016.
Nurses present prize-winning posterVirginia Capasso, RN, nurse
practitioner; Amanda Bulette Coakley, RN, staff specialist; Vivian Donahue, RN, nursing director;
Susan Stengrevics, RN, clinical nurse specialist; Katie Feins, RN, staff nurse; Theresa Gallivan, RN, associate chief
nurse; and Gaurdia Banister, RN, executive director of The Institute for Patient Care; presented their poster, “Effect of Fluid Immersion
Simulation Mattress on Prevention of Hospital-Acquired Pressure Ulcers in Highest Risk Cardiac Surgical Patients,” at the World
Union of Wound Healing Societies in Florence, Italy, September 25-29,
2016. Their entry won Best Poster.
O’Connell presentsDenise O’Connell, LCSW, senior program manager, Lunder-Dineen
Health Education Alliance of Maine, presented, “The Lunder-Dineen
MOTIVATE Program,” to the Maine Dental Hygienists’ Association in Auburn and Brewer, Maine, September 9 and 16, 2016.
Golden-Baker presentsSheila Golden-Baker, RN,
clinical educator, presented, “Peer Review: Incorporating Innovative
Concepts of Professional Development into Practice,” at the seventh annual Nursing Symposium
at Fudan University Huashan Hospital in Shanghai, China,
September 21, 2016.
Inter-professional team publishes
Chris Laux, RN; Mary McKenna Guanci, RN; Stephen Figueroa, MD; Kerry Francis, RPh; Sarah Livesay,
RN; and Charlene Mathiesen, RN, authored the article, “Clinical
Q&A: Translating Therapeutic Temperature Management from
Theory to Practice,” in the August, 2016, Therapeutic Hypothermia and
Temperature Management.
McKenna Guanci presents
Mary McKenna Guanci, RN, clinical nurse specialist, Neurology, presented, “Neurologic Decline,
Cortical Spreading Depression, and The Role of Electrocorticography
in the Management of the Neuroscience Patient,” at the
annual meeting of the American Association of Neuroscience
Nurses, in New Orleans, on April 10, 2016.
Guanci also presented, “Multidisciplinary Care and Family Rounding in the Neuro Intensive
Care Unit, at the 14th annual meeting of the Neurocritical
Care Society in National Harbor, Maryland, September 15, 2016.
Arnstein appointedPaul Arnstein, RN, clinical nurse
specialist, was appointed a representative to the Governor’s Pain Treatment Education Special Commission in September, 2016.
Stieb presentsElisabeth Stieb, RN, staff nurse, Food Allergy Center, Newton Wellesley Hospital, presented, “Daily Management of Food Allergies,” at the west coast
conference of the American Society of Allergy Nurses, in Seaside, Oregon, September 25, 2016.
McKenna Guanci, appointed
Mary McKenna Guanci, RN, clinical nurse specialist, Neurology,
was appointed chair of the Nursing Awards Committee
for the American Association of Neuroscience Nurses,
earlier this year.
Nurse practitioners publish
Barbara Wuerthner, RN, nurse practitioner, and Maria Avila-
Wallace, RN, nurse practitioner, authored the article, “Cervical
Cancer: Screening, Management, and Prevention,” in the September,
2016, The Nurse Practitioner.
Inter-professional team publishes
Mary McKenna Guanci, RN; Herbert Fried, MD; Nathan Bart, MD; Shaun Rowe, RPh; Joseph
Zabamski, MD; Andaluz Nomberto, MD; Bhimra Adarsh, MD; David Seder, MD; and Jeff Singh, MD,
authored the article, “The Insertion and Management of External
Ventricular Drains: an Evidence-Based Consensus Statement —
a Statement for Healthcare Professionals from the Neurocritical
Care Society,” in the February, 2016, Neurocritical Care.
November 3, 2016 — Caring Headlines — Page 15
Published byCaring Headlines is published twice each month by the department of
Nursing & Patient Care Services at Massachusetts General Hospital
PublisherJeanette Ives Erickson, RN
senior vice presidentfor Patient Care
Managing EditorSusan Sabia
Editorial Advisory BoardChaplaincy Reverend John Polk
Disability Program Manager Zary Amirhosseini
Editorial Support Marianne Ditomassi, RN Mary Ellin Smith, RN Maureen Schnider, RN
Informatics Ann Marie Dwyer, RN
Medical Interpreters Anabela Nunes
Materials Management Edward Raeke
Nutrition & Food Services Donna Belcher, RD Susan Doyle, RD
Office of Patient Advocacy Robin Lipkis-Orlando, RN
Office of Quality & Safety Colleen Snydeman, RN
Orthotics & Prosthetics George Reardon
PCS Diversity Deborah Washington, RN
Physical TherapyOccupational Therapy Michael Sullivan, PT
Police, Security & Outside Services Joe Crowley
Public Affairs Colleen Marshall
Respiratory Care Ed Burns, RRT
Social Work Ellen Forman, LICSW
Speech, Language & Swallowing Disorders and Reading Disabilities Carmen Vega-Barachowitz, SLP
Training and Support Staff Gino Chisari, RN
The Institute for Patient Care Gaurdia Banister, RN
Volunteer Services Jacqueline Nolan
DistributionMilton Calderon, 617-724-1755
SubmissionsAll stories should be submitted
to: ssabia@partners.orgFor more information, call:
617-724-1746
Next PublicationNovember 17, 2016
Announcements
Blum Center Events“Weight Bias in the Medical
Setting”Thursday, November 10, 2016
12:00–1:00pmLisa Du Breuil, LICSW, and Anne Emmerich, MD, will discuss weight
bias and its impact on patient health outcomes.
Shared Decision Making: “Living with Diabetes: Making Lifestyle Changes to Last a
Lifetime”Monday, November 14th
12:00–1:00pmEnrico Cagliero, MD, will lead a discussion about diabetes care.
“Understanding Lupus”Friday, November 18th
12:00–1:00pmJoin April Jorge, MD, to learn
about the symptoms, causes, and treatments for lupus.
Programs are free and open to MGH staff and patients.No registration required.
All sessions held in the Blum Patient & Family Learning Center.
For more information,call 4-3823.
ACLS ClassesCertification:
Two-day programDay one:
November 10, 20168:00am–3:00pm
Day two:November 11th8:00am–1:00pm
Re-certification (one-day class):January 11, 20175:30–10:30pm
ACLS Instructor ClassDecember 2, 20167:00am–3:00pm
Location to be announced.For information, send e-mail to:
acls@partners.org, or call617-726-3905
To register, go to:http://www.mgh.harvard.edu/emergencymedicine/assets/
Library/ACLS_registration%20form.pdf.
The MGH Blood Donor Center
The MGH Blood DonorCenter is located in the lobbyof the Gray-Jackson Building.
The center is open for whole-blood donations:
Tuesday, Wednesday, Thursday,7:30am–5:30pm
Friday, 8:30am – 4:30pm
(closed Monday)
Platelet donations:
Monday, Tuesday, Wednesday, Thursday,
7:30am–5:00pm
Friday, 8:30am–3:00pm
Appointments are available
Call the MGH Blood Donor Center at 6-8177 to schedule
an appointment.
Make yourpractice visible: submit
a clinical narrativeCaring Headlines is always
interested in receiving clinical narratives that highlight the
exceptional care provided by clinicians throughoutPatient Care Services.
Make your practice visible.Submit your narrative for
publication in Caring Headlines.All submissions should be sent via
e-mail to: ssabia@partners.org.For more information,
call 4-1746.
Page 16 — Caring Headlines — November 3, 2016
HeadlinesNovember 3, 2016
First ClassUS Postage PaidPermit #57416
Boston, MA
Returns only to:Volunteer Department, GRB-B 015
MGH, 55 Fruit StreetBoston, MA 02114-2696
Data is complete through July, 2016, with partial data through October. MGH is performing well in Overall Rating and Discharge Information.
HCAHPS
All results reflect Top-Box (or ‘Always’ response) percentages
Inpatient HCAHPSCurrent data
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